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目的利用磁敏感加权成像(SWI)了解弥漫性轴索损伤(DAI)出血灶的表现并探讨SWI在外伤性DAI中出血灶的应用价值。资料与方法20例DAI患者行3.0T磁共振SWI。观察DAI脑内出血灶在SWI上的形态、分布、数目等,并与昏迷程度、昏迷天数以及预后等进行对比或相关分析。结果DAI的出血灶在SWI像上表现为斑点状,线条状,小团状低信号,病灶最大径最大者15mm,最小者<0.5mm。DAI出血灶在脑表浅部分布较后颅窝和脑深部多。DAI出血灶总数分别与格拉斯哥昏迷评分(GCS)和昏迷天数呈负相关(r=-0.931,P=0.000)和正相关(r=0.924,P=0.000)。预后不良组患者DAI出血灶数大于恢复良好组。结论SWI有助于显示DAI出血灶,从而能够较好地解释DAI的临床症状,并对判断DAI患者的预后亦有一定价值。
Objective To evaluate the performance of hemorrhagic lesions of diffuse axonal injury (DAI) by using magnetic resonance weighted imaging (SWI) and explore the value of SWI in hemorrhagic lesions of traumatic DAI. Materials and Methods Twenty patients with DAI underwent 3.0T MRI. The morphological, distribution and number of hemorrhagic lesions in the brain of DAI were observed and compared with those of coma, days of coma and prognosis. Results The hemorrhagic lesions of DAI showed a speckled, linear, small, low signal on the SWI images. The largest diameter of lesions was 15mm and the smallest was <0.5mm. DAI hemorrhage in the superficial part of the brain than the posterior fossa and deep brain more. The total number of DAI lesions was negatively correlated with GCS and coma days, respectively (r = -0.931, P = 0.000) and positive correlation (r = 0.924, P = 0.000). In the poor prognosis group, the number of DAI hemorrhage was larger than that in the well-recovered group. Conclusion SWI can help to show DAI hemorrhagic foci, which can explain the clinical symptoms of DAI better and have certain value in judging the prognosis of DAI patients.